title: The STRONG(kids) nutritional screening tool in hospitalized children: a validation study.
abstract: OBJECTIVE
  The STRONGkids is a nutritional screening tool for hospitalized children, which was found to predict a negative weight for height (WFH) standard deviation score (SDS) and a prolonged hospital length of stay (LOS) in a Dutch population of hospitalized children. This study aimed to test the ease of use and reproducibility of the STRONGkids, and to confirm its concurrent and prospective validity in a Belgian population of hospitalized children.
  
  
  METHODS
  Reproducibility was tested in a cohort of 29 hospitalized children in a tertiary center and validity was tested in 368 children (105 hospitalized in a tertiary and 263 in three secondary hospitals) ages between 0.08 and 16.95 y (median 2.2 y).
  
  
  RESULTS
  Substantial intrarater (κ = 0.66) and interrater (κ = 0.61) reliabilities were found between observations. STRONGkids scores correlated negatively with WFH SDS of the patients (ρ = -0.23; P < 0.01; odds ratio [OR], 2.47; 95% confidence interval [CI], 1.11-5.49; P < 0.05). It had a sensitivity and negative predictive value (NPV) of respectively 71.9% and 94.8% to identify acutely undernourished children. STRONGkids did not correlate with weight loss during hospitalization, but correlated with LOS (ρ = 0.25; OR 1.96; 95% CI, 1.25-3.07; both P < 0.01) and the set-up of a nutritional intervention during hospitalization (OR, 18.93; 95% CI, 4.48-80.00; P < 0.01). The sensitivity and NPV to predict a LOS ≥ 4 d were respectively 62.6% and 72%, and respectively 94.6% and 98.9% to predict a nutritional intervention.
  
  
  CONCLUSIONS
  STRONGkids is an easy-to-use screening tool. Children classified as "low risk" have a 5% probability of being acutely malnourished, with only a 1% probability of a nutritional intervention during hospitalization.
authors.affiliation: Department of Paediatrics, UZ Brussel, Brussels, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Huysentruyt
authors.forename: Philippe
authors.initials: P
authors.lastname: Alliet
authors.forename: Laurence
authors.initials: L
authors.lastname: Muyshont
authors.forename: Roxane
authors.initials: R
authors.lastname: Rossignol
authors.forename: Thierry
authors.initials: T
authors.lastname: Devreker
authors.forename: Patrick
authors.initials: P
authors.lastname: Bontems
authors.forename: Joachim
authors.initials: J
authors.lastname: Dejonckheere
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
authors.forename: Jean
authors.initials: J
authors.lastname: De Schepper
mesh_terms: D000293:Adolescent; D001530:Belgium; D001827:Body Height; D001835:Body Weight; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D016017:Odds Ratio; D011446:Prospective Studies
keywords: Child; Hospitalized; Malnutrition; Nutritional screening; Sensitivity; Specificity